Article

The aim of this study is to identify early predictors of refractory epilepsy.
From 600 epileptic children followed for at least 2 years in the department of
neurology of Charles Nicolle hospital of Tunis, were identified children with
refractory epilepsy. Controls were children who responded well to antiepileptic
drugs and who were seizure free for at least 2years. We collected anamnestic,
clinical, neuropsychological and radiological data for all children. We
identified 67 children with refractory epilepsy, representing 11.6% of the
initial population. At diagnosis, the average age was 9.16 years. Some factors
have been identified as predictors of drug resistance epilepsy: age of onset less
than one year, partial and atonic seizure, combination of several types of
attacks, presence of mental retardation and pyramidal syndrome, abnormal
electroencephalogram especially focal abnormalities, spike, amplitude
abnormalities, interhemispheric asymmetry; and resistance to first antiepileptic
drug. Symptomatic epilepsy, especially if associated with radiological lesions
such as hippocampal sclerosis and structural brain malformations, was highly
correlated with drug resistance. Our study suggests that the initial presentation
of epilepsy could predict long-term outcome to drug resistance epilepsy if a
detailed analysis of anamnestic, clinical and complementary data is established.
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Langue : FRANCAIS